Working together for pediatric care

February 23, 2008

It's been tough for parents on South Bend's west side to find doctors in their neighborhood to treat their sick children. So, they'll be grateful if Memorial Hospital and Saint Joseph Regional Medical Center follow through on a proposal announced last month during a South Bend Redevelopment Commission meeting to open a joint-venture family practice on Bendix Drive. Families of children diagnosed with complex medical conditions must be grateful, too, that both SJRMC and Memorial are gearing up to offer more specialized pediatric care here. In the past, children with serious health issues were sent to Riley Hospital for Children in Indianapolis, a daylong trip away from home and community support. Riley already contributes to SJRMC's cardiology, endocrinology and diabetology, gastroenterology and rheumatology programs. Now, Riley will extend help with neurology, remote diagnosis and treatment, along with sophisticated education for local providers and caregivers. Memorial last year announced plans to develop a children's hospital after it completes its $80 million expansion for new operating rooms and a cancer center. It's already recruiting physicians. But what if the hospitals joined efforts on a single center, with all the best equipment, where all the best doctors could consult on a course of treatment? Might that be better for young patients? Might it be more efficient? More cost effective? Easier for stressed parents? During the 1960s and '70s, the two institutions worked closely together through the St. Joseph County Hospital Development Inc., creating one of the Midwest's most efficient health care systems. In those years, for example, Memorial provided psychiatric services and St. Joseph handled rehabilitation. Memorial offered obstetrics; St. Joseph, renal dialysis. New market pressures emerged, a federally mandated requirement for health care providers to prove the need for new programs and equipment faded away by the mid-'80s, and the old cooperative fell apart. Today, Douglas Leonard, president of the Indiana Hospital Association, says institutions are more financially strained and less willing to opt out of programs that will pay for themselves or, better yet, subsidize less profitable yet necessary services such as AIDS treatment and burn units. (Ironically, he says, economics also has forced mergers between institutions that can't sustain themselves without an alliance for efficiencies of size.) Consumers' demand for choice and the difficulty of pulling together physicians who often function as independent businesses also work against collaboration, he says. Still, the West Michigan Cancer Center in Kalamazoo is proof that joint ventures can be enormously successful. Borgess Hospital and Bronson Methodist Hospital, one Catholic and one not, opened the cancer center in 1994. Its president, Terry McKay, says scrutiny of the intense competition between the two hospitals which landed their dueling helicopter services in the public spotlight, along with pressure from the community's then-major employer Upjohn Co. for lower employee health care costs, conspired to push the hospitals to cooperate. They merged the helicopter services. They established a joint laundry. But the jewel of the efforts that emerged is the cancer center -- financially sound with an excellent reputation in the community and patient satisfaction consistently rising to 97 percent. The center routinely is first with the industry's best technology, McKay is convinced, because both hospitals are driving excellence. She says a pediatric specialty clinic may well be worth exploring as a joint venture.